39D2008549 CLIA NUMBER - COTTMAN KIDNEY CENTER

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Laboratory Demographics

CLIA Number: 39D2008549

Facility Name: COTTMAN KIDNEY CENTER

Facility Address:
7198 CASTOR AVENUE
PHILADELPHIA, PA
ZIP 19149
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Facility Phone Number: 215 745-4060

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1881911998

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	39D2008549
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	COTTMAN KIDNEY CENTER
Street	7198 CASTOR AVENUE
City	PHILADELPHIA
State	PA
ZIP	19149
Phone	215 745-4060
CertificateType	4
CertificateEffectiveDate	6/14/2022
CertificateExpirationDate	6/13/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024